New Treatment for Barrett's Esophagus
Radiofrequency Ablation Zaps
Barrett's Esophagus, Reduces Cancer Risk
By Jennifer Warner
WebMD Health News
Reviewed by Louise Chang, MD
May 27, 2009 -- Radiofrequency ablation may zap away the potentially
precancerous cells associated with
Barrett's esophagus.
A new study shows radiofrequency ablation, which uses
heat generated by radio waves to selectively destroy tissue, completely
eradicated the abnormal cell
growths lining the esophagus in more than 77% of those who received the
treatment.
Barrett's esophagus is usually the result of GERD
(gastroesophageal reflux
disease), in which repeated acid reflux causes the cells that line the esophagus
to be replaced by the type of cells normally found in the intestine. Most people
with GERD will not develop Barrett's esophagus. According to background
information noted in the study, about 10% of people with chronic GERD will
develop Barrett's esophagus.
The condition itself is not life-threatening, but a small
proportion of people with Barrett's esophagus go on to develop esophageal
adenocarcinoma, one
of the most deadly forms of cancer.
New Option for Barrett's Esophagus
Until now, the only other option to reduce the risk of
cancer growth from abnormal cells was surgery. Radiofrequency ablation is a much less invasive
option.
In the study, researchers compared the effectiveness of
the radiofrequency ablation treatment to destroy abnormal cells in the esophagus
vs. a sham treatment in 127 people with Barrett's esophagus. Both procedures
involved endoscopy, or the passage of a catheter through the mouth into the esophagus.
During the radiofrequency ablation treatment, a balloon with a set of
electromagnetic coils is placed at the site of the abnormal cell growth in the
esophagus.
"Energy is then passed through the electromagnetic coils
and, because we know how far apart the coils are spaced and how much energy is
being put through them, we get a very reliable depth of burn, such that you can
kill the abnormal cells on the inner surface without damaging the whole organ," researcher
Nicholas Shaheen, MD, associate professor at the University of North Carolina at
Chapel Hill Schools of Medicine, says in a news release.
Overall, the results show that 77.4% of those treated with radiofrequency
ablation had a complete eradication of the abnormal cell growth compared with
2.3% in the sham group 12 months after treatment.
In addition, significantly fewer of those with Barrett's
esophagus treated with radiofrequency ablation had esophageal cancer within the study's 12-month
follow-up period, 1.2% vs. 9.3%.
There were no deaths related to the procedure. The
authors note three adverse events among the radiofrequency ablation
participants: a patient with gastrointestinal hemorrhage who was also taking
anti-clotting medication for heart disease, another with new chest pain that
developed eight days after the procedure, and a patient who reported chest
discomfort and nausea soon after the
procedure.
Other types of ablation have been studied in treating Barrett's esophagus,
but experts say these results, published in the New England Journal of Medicine,
are the most promising so far.
Even so, more study is needed to determine the best candidate for the
procedure before radiofrequency ablation is promoted as a widespread treatment
for Barrett's esophagus, says Jacques J.G.H.M Bergman, MD, PhD, of the Academic
Medical Center in Amsterdam, Netherlands, in an editorial that accompanies the
study.
SOURCES:
Shaheen, N. The New England Journal of Medicine, May 28, 2009; vol 360: pp
2277-2288.
News release, University of North Carolina at Chapel Hill.
© 2009 WebMD, LLC. All rights reserved.
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